Revision After Frontalis Suspension With Autogenous Fascia Lata For Congenital Ptosis

ObjectiveTo investigate the reason of upper eyelid deformities requiring revision after frontalis suspension using fascia lata autografts for congenital ptosis, and to assess functional and cosmetic outcomes after the release of fascia lata.DesignA retrospective analysis of Observational case seriesMethodsSeventeen patient with congenital ptosis after frontalis suspension using fascia lata autografts requiring revision were enrolled from July 2013 to January 2016 in Ophthalmic Center of the second affiliated hospital of Zhejiang University. The clinical characteristics were analyzed based on the records. All the patients underwent the revision to release the grafted fascia lata. Functional and cosmetic success was assessed by review of photographs.ResultsAmong the 17 patients (13 male patients,4 female patients), the average age of revision was 23.8 years old. The Mean preoperative palpebral fissure height of the affected eyes was 3.52±1.17mm (2-5mm), and Mean levator excursion was 2.38±0.74mm (1-4mm).The main reason of revision was the poor lid contour, symmetry, and erased crease.23.5% patients had the eyelash inversion problem. Unsatisfied outcomes were found at more than 6 months after surgery in 82.3%patients. All these cases underwent the secondary surgery to release the grafted fascia lata. The followup time ranged from 3 to 32 months (median,15.9 months),76.4% patient achieved satisfied functional and cosmetic outcomes after the revision.ConclusionsThe use of fascia lata autografts for severe ptosis resulted in good outcomes, and the contracture of the grafted fascia lata may lead to the secondary operation. Releasing the grafted fascia lata and enhance the double eyelid is an effective method to revision.